Role of Radiofrequency Ablation in Patients with Hepatocellular Carcinoma Who Undergo Prior Transarterial Chemoembolization: Long-Term Outcomes and Predictive Factors

• Published in: Gut and liver Vol. 8; no. 5; pp. 543 - 551
• Main Authors: Sohn, Won, Choi, Moon Seok, Cho, Ju Yeon, Gwak, Geum-Youn, Paik, Yong-Han, Lee, Joon Hyeok, Koh, Kwang Cheol, Paik, Seung Woon, Yoo, Byung Chul
• Format: Journal Article
• Language: English
• Published: Korea (South) Gut and Liver 01.09.2014; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Aged; alpha-Fetoproteins - analysis; carcinoma; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - therapy; Catheter Ablation; Chemoembolization, Therapeutic - mortality; Combined Modality Therapy - mortality; Female; hepatocellular; Humans; Liver Neoplasms - mortality; Liver Neoplasms - therapy; Male; Middle Aged; Neoplasm Recurrence, Local - mortality; Original; outcome; radiofrequency ablation; recurrence; Survival Rate; transarterial chemoembolization; Treatment Outcome; 내과학; Carcinoma, hepatocellular; Radiofrequency ablation; Recurrence; Outcome; Transarterial chemoembolization
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl13356

The role of radiofrequency ablation (RFA) remains uncertain in patients with viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). A total of 101 patients (April 2007 to August 2010) underwent RFA for residual or recurrent HCC after TACE. We analyzed their long-term outcomes and predictive factors. The overall survival rates after RFA were 93.1%, 65.4%, and 61.0% at 1, 3, and 5 years, respectively. Predictive factors for favorable overall survival were Child-Pugh class A (hazard ratio [HR], 3.45; p=0.001), serum α-fetoprotein (AFP) level <20 ng/mL (HR, 2.90; p=0.02), and recurrent tumors after the last TACE (HR, 3.14; p=0.007). The cumulative recurrence-free survival rate after RFA at 6 months was 50.1%. Predictive factors for early recurrence (within 6 months) were serum AFP level ≥20 ng/mL (HR, 3.02; p<0.001), tumor size ≥30 mm at RFA (HR, 2.90; p=0.005), and nonresponse to the last TACE (HR, 2.13; p=0.013). Patients with recurrent or residual HCC who undergo prior TACE show a favorable overall survival, although their tumors seem to recur early and frequently. While good liver function, a low serum AFP level, and recurrent tumors were independent predictive factors for a favorable overall survival, poor response to TACE, a high serum AFP level, and large tumors are associated with early recurrence.